I had an allergic reaction to shrimp somewhere around 1990. It reminded me of a bit of an asthma attack, with some lip swelling thrown in for good measure. Since then, I just didn't eat shellfish, and have never had a major reaction, but was never officially tested. A year or so ago, my wife and I were thinking of doing some travelling, the allergy thing came up, so I had a RAST done. Sure enough, 2H to shrimp, 1H to lobster. Since then, I have been very freaky about what I eat. I started looking up the allergen lists from restaurants online, reading lablels, etc., and the whole thing is making me crazy! I cannot make myself go out to eat... scares the h@$# out of me! I have yet to see an allergist, and also have mild asthma.

So... couple of questions:

First... despite the positive RAST, if I haven't had a problem, should I be any more worried than before? My wife thinks I am being irrational, and since we used to eat out frequently this is a big issue.

Second... does anyone have any experience with RAST reliability? As in the test not being reliable.

Rationally, I can see the argument that I'm making this a mountain out of a molehill. Practically, I can't seem to get past it, and it is seriously affecting my life.

Hi Steve and welcome! Why don't you ask to be referred to an allergist? Allergy testing is not straight forward. It takes into account your history, medical conditions and specific tests. You might consider a skin prick test to see if you are reacting to the foods in question. The next step would be an oral challenge under medical supervision.

You say you've reacted in the past and you have asthma-that's 2 checks on the risk factor scale. Speak to your Dr about a referral and about the possible need for an Epipen.

Hi Steve,
Ouch - 1990 is a long time ago. I was diagnosed a few years after you - thanks to anaphylaxis to shrimp. Those asthma symptoms: probably part of the food reaction.

The RAST isn't fully reliable, but those level of results are usually a good indicator there is an allergy. Most allergists like to see both the blood work and a skin test. I'd also definitely ask about getting prescribed an EpiPen if you don't have one - I know I don't feel fearful eating out (and my inaugural shrimp reaction was a doozy), but I would feel trepidation if I didn't have my Epi. (In fact, I just don't eat out without it.) It's like wearing a life jacket in case you get tossed into deep waters.

You should be able to avoid crustaceans eating out. Lots of good, mid-price restaurants have chefs who pride themselves on having the kitchen control to accommodate special diet needs.

Few steps you can try:
- Once you have an Epi (if you don't already), check out a few resto menus online. Try something like Italian or Indian or just modern Amer. cuisine without much seafood on the menu.
- Phone the restaurant after the lunch crush, but before dinner rush, and talk to the manager about whether they can accommodate allergies, avoid cross-contact in the kitchen. Most are pretty used to seafood allergies; crustaceans are the biggest allergy with adults. I get the manager to mark down allerges with my reservation, then I up the allergies with the waiter once i'm at the restaurant. I find most servers really good about checking ingredients with the chef when they're not sure.

In your shoes, I'd want to work on the fear that has no festered for too many years. Maybe try taking your wife out for dessert at a nice local restaurant. You can just have a coffee. But grab a chat with the manager about your allergies. Talk to him/her about the menu in person. If you feel comfortable with how the manager handles the situation, make a reservation for, maybe, lunch. Make it later, when they're not as busy. Have your Epi and your wife with her cell, just so you know you're covered in case something goes wrong.

Sounds like you need small steps just to break through the fear, which with anaphylaxis can be pretty profound. And I bet your wife would be so happy if you two could go out again. Like I say, could a coffee at a non-seafood resto hurt?

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